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Safety, Tolerability, and Antiviral Activity of 24 or 48 Weeks of GS-9190 in Combination With Peginterferon Alfa 2a and Ribavirin for the Treatment of Genotype-1 Chronic HCV Infection

Primary Purpose

HCV Infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
placebo
GS-9190
Peginterferon Alfa 2a
Ribavirin
Sponsored by
Gilead Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HCV Infection focused on measuring Hepatitis C, HCV, Rapid Virologic Response, Sustained Virologic Response, HCV RNA, Polymerase inhibitor, GS-9190

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult subjects (18 - 70 years of age)
  • Chronic HCV infection for at least 6 months prior to Baseline (Day 1) (anti-HCV antibody positive; positive for plasma HCV RNA; medical history consistent with chronicity accepted by the investigator)
  • Liver biopsy results within the past 2 years prior to Baseline (Day 1) indicating the absence of cirrhosis
  • HCV treatment-naive, defined as no prior exposure to PEG, RIBA, or experimental HCV therapy
  • Mono-infection with HCV genotype 1a or 1b
  • Detectable plasma HCV RNA at Screening
  • BMI between 19 and 36 kg/m2
  • Willing and able to provide written informed consent and to comply with all study requirements
  • Of generally good health as determined by the Investigator
  • Subject agrees to use adequate skin protection (e.g., sunblocking agent) when exposed to the sun.
  • Women of childbearing potential (i.e., a non-menopausal female or a female with menopausal < 2 years, who has not had a hysterectomy, bilateral oophorectomy or medically documented ovarian failure) must have negative serum β-human chorionic gonadotropin (hCG) at screening and negative urine pregnancy test prior to the first study drug administration.
  • All subjects (male and female) must agree to utilize highly effective contraception methods (two separate forms of contraception, one of which must be an effective barrier method, or be non-heterosexually active, practice sexual abstinence or have a vasectomized partner) from screening throughout the duration of study treatment and for 24 weeks after the last dose of RIBA.
  • Female subjects who utilize hormonal contraceptive as one of their birth control methods must have used the same method for at least three months prior to study dosing.
  • Female subjects who are postmenopausal for less than two years are required to have FSH > 40 mIU/mL. If the FSH is ≤ 40 mIU/mL, the subject must agree to use highly effective method of birth control (as described above) to participate in the study.
  • Male subjects who are sexually active must be willing to use effective barrier contraception (e.g., condom with spermicide) during heterosexual intercourse from screening through completion of the study and continue for 24 weeks after the last dose of RIBA

Exclusion Criteria:

  • Pregnant or breast feeding women or women who may wish to become pregnant during the course of the study
  • Males who have partners planning to become pregnant
  • Males and females of reproductive potential who are unwilling to use two forms of effective birth control through Study Week 72. One method should include a condom with spermicide for males
  • Infection with non-genotype 1 HCV
  • Poorly controlled diabetes mellitus (hemoglobin A1c > 7) unless treatment intervention has been reviewed with the Medical Monitor and improved glucose control is anticipated
  • History of sarcoidosis
  • History of hemoglobinopathy (e.g., thalassemia)
  • History of known retinal disease
  • History of invasive malignancy diagnosed or treated within 5 years (recent localized treatment of squamous or non-invasive basal cell skin cancers is permitted; cervical carcinoma in situ is allowed if appropriately treated prior to screen)
  • Evidence of hepatocellular carcinoma
  • Chronic liver disease of a non-HCV etiology
  • Untreated or significant psychiatric illnesses including severe depression, schizophrenia, psychosis, or a history of a suicide attempt
  • Co-infection with HIV, HBV, or multiple HCV genotypes
  • Chronic use of systemic immunosuppressive agents
  • Presence of autoimmune disorders. Subjects with treated hypothyroidism with normal TSH may be enrolled.
  • Severe chronic obstructive pulmonary disease
  • History of clinically significant cardiac disease, including a family history of Long QT Syndrome, and/or evidence of the following ECG abnormalities at screening: QTcF (QT corrected using Fridericia's formula) of > 450 msec; complete or incomplete left or right bundle branch block; intraventricular conduction delay with QRS duration of > 120 msec; bradycardia (< 45 beats per minute); pathologic Q-waves (Q wave of > 40 msec or depth of > 0.4 to 0.5 V); arrhythmia (an isolated premature ventricular contraction on screening/Day 1 is not exclusionary) ; ventricular pre excitation; second or third degree heart block
  • Positive urine screen for amphetamines or cocaine
  • Known, current heroin, morphine, or methadone use
  • Ongoing alcohol abuse in the judgment of the investigator (in no case intake of more than 28 units of alcohol per week [1 unit = ½ pint of beer, 1 glass of wine, 1 shot of spirits])
  • Receiving a known potent CYP 3A4 inhibitor within 2 weeks of study drug dosing or are expected to receive such therapy during the course of study drug dosing
  • Known hypersensitivity to the study drugs, their metabolites or formulation excipients
  • In the judgment of the Investigator, should not participate in the study due to potential clinical or compliance issues

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

1

2

3

Arm Description

Peginterferon and ribavirin + placebo BID for 48 weeks + 24 weeks treatment-free follow-up (n = 50)

Peginterferon and ribavirin + GS 9190 40 mg BID for 48 weeks + 24 weeks treatment-free follow-up (n = 100)

Peginterferon and ribavirin + GS 9190 40 mg BID for 48 weeks + 24 weeks treatment-free follow-up. However, subjects who achieve RVR (HCV RNA undetectable at Week 4) and maintain that response through Week 24 will stop all study drugs at Week 24 and be followed for an additional 48 weeks (n = 50).

Outcomes

Primary Outcome Measures

Undetectable HCV RNA level

Secondary Outcome Measures

Safety and tolerability
Undetectable HCV RNA level
GS-9190 plasma concentrations
Undetectable HCV RNA

Full Information

First Posted
August 27, 2008
Last Updated
October 11, 2013
Sponsor
Gilead Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT00743795
Brief Title
Safety, Tolerability, and Antiviral Activity of 24 or 48 Weeks of GS-9190 in Combination With Peginterferon Alfa 2a and Ribavirin for the Treatment of Genotype-1 Chronic HCV Infection
Official Title
A Phase 2b, Randomized, Double-Blind, Placebo-Controlled Trial Comparing 24 or 48 Weeks of GS 9190, in Combination With Peginterferon Alfa 2a and Ribavirin, to 48 Weeks of Peginterferon Alfa 2a and Ribavirin for the Treatment of Genotype-1 Chronic Hepatitis C Virus (HCV) Infection (GS-US-196-0103)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
October 2008 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
September 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gilead Sciences

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to compare the safety, tolerability and effectiveness of the experimental drug GS-9190 when administered for 24 or 48 weeks with peginterferon alfa 2a and ribavirin for the treatment of genotype-1 chronic hepatitis C infection.
Detailed Description
The safety, tolerability and antiviral efficacy GS-9190, administered orally twice daily at 40 mg, will be compared to placebo when used in combination with peginterferon alfa 2a (PEG) and ribavirin (RIBA) in treatment-naïve subjects chronically infected with HCV genotype 1 infection. Two-hundred forty-eight (248) subjects will be randomized (ratio: 1:2:1) to one of three treatment arms: Arm 1: PEG/RIBA + placebo BID for 48 weeks + 24 weeks treatment-free follow-up (n = 62) Arm 2: PEG/RIBA + GS 9190 40 mg BID for 48 weeks + 24 weeks treatment-free follow-up (n = 124) Arm 3: PEG/RIBA + GS 9190 40 mg BID for 48 weeks + 24 weeks treatment-free follow-up. However, subjects who achieve RVR (HCV RNA undetectable at Week 4) and maintain that response through Week 24 will stop all study drugs at Week 24 and be followed for an additional 48 weeks (n = 62). Randomization will be stratified by plasma HCV RNA level (< or ≥ 400,000 IU/mL) at screening and race (of African descent or other). In order to ensure adequate representation of subjects with genotypes 1a and 1b in this trial, enrollment for either genotype will be capped at 120 subjects. Once 120 subjects of either genotype (e.g., genotype 1a) have been randomized, subsequent enrollment will only be allowed for subjects with the other genotype (e.g., genotype 1b). The duration of double-blind treatment is 48 weeks plus 24 weeks of treatment-free follow-up; however subjects in Arm 3 will stop all medication at Week 24 if they have achieved an RVR (defined by undetectable HCV RNA following 4 weeks on therapy) and have maintained that response thereafter. Subjects will only learn that they have been randomized to Arm 3 if, at Week 24, having achieved criteria for stopping therapy, they are instructed to stop. All other subjects will remain blinded to their treatment status throughout the course of the study. The standard of care treatment stopping criterion used in clinical practice when treating HCV with PEG/RIBA, failure to achieve EVR, will be utilized in this trial. Additionally, subjects with detectable plasma HCV RNA at Week 24 will discontinue all study medications no later than the Week 28 visit and will be followed off-treatment for 24 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HCV Infection
Keywords
Hepatitis C, HCV, Rapid Virologic Response, Sustained Virologic Response, HCV RNA, Polymerase inhibitor, GS-9190

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
252 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Placebo Comparator
Arm Description
Peginterferon and ribavirin + placebo BID for 48 weeks + 24 weeks treatment-free follow-up (n = 50)
Arm Title
2
Arm Type
Experimental
Arm Description
Peginterferon and ribavirin + GS 9190 40 mg BID for 48 weeks + 24 weeks treatment-free follow-up (n = 100)
Arm Title
3
Arm Type
Experimental
Arm Description
Peginterferon and ribavirin + GS 9190 40 mg BID for 48 weeks + 24 weeks treatment-free follow-up. However, subjects who achieve RVR (HCV RNA undetectable at Week 4) and maintain that response through Week 24 will stop all study drugs at Week 24 and be followed for an additional 48 weeks (n = 50).
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
oral BID
Intervention Type
Drug
Intervention Name(s)
GS-9190
Intervention Description
40 mg oral BID
Intervention Type
Drug
Intervention Name(s)
Peginterferon Alfa 2a
Other Intervention Name(s)
PEG
Intervention Description
All subjects received a fixed dose of 180 μg PEG via subcutaneous injection on a weekly basis.
Intervention Type
Drug
Intervention Name(s)
Ribavirin
Other Intervention Name(s)
RBV
Intervention Description
Ribavirin supplied as 200 mg Copegus® tablets (1000 mg for subjects weighing < 75 kg and 1200 mg for subjects weighing ≥ 75 kg) were given in a divided daily dose.
Primary Outcome Measure Information:
Title
Undetectable HCV RNA level
Time Frame
At Week 12 for Early Virologic Response (EVR)
Secondary Outcome Measure Information:
Title
Safety and tolerability
Time Frame
Throughout 72 week study period
Title
Undetectable HCV RNA level
Time Frame
Week 4, Week 24 and Week 48
Title
GS-9190 plasma concentrations
Time Frame
Through Week 48
Title
Undetectable HCV RNA
Time Frame
At Week 72 for sustained virologic response (SVR)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult subjects (18 - 70 years of age) Chronic HCV infection for at least 6 months prior to Baseline (Day 1) (anti-HCV antibody positive; positive for plasma HCV RNA; medical history consistent with chronicity accepted by the investigator) Liver biopsy results within the past 2 years prior to Baseline (Day 1) indicating the absence of cirrhosis HCV treatment-naive, defined as no prior exposure to PEG, RIBA, or experimental HCV therapy Mono-infection with HCV genotype 1a or 1b Detectable plasma HCV RNA at Screening BMI between 19 and 36 kg/m2 Willing and able to provide written informed consent and to comply with all study requirements Of generally good health as determined by the Investigator Subject agrees to use adequate skin protection (e.g., sunblocking agent) when exposed to the sun. Women of childbearing potential (i.e., a non-menopausal female or a female with menopausal < 2 years, who has not had a hysterectomy, bilateral oophorectomy or medically documented ovarian failure) must have negative serum β-human chorionic gonadotropin (hCG) at screening and negative urine pregnancy test prior to the first study drug administration. All subjects (male and female) must agree to utilize highly effective contraception methods (two separate forms of contraception, one of which must be an effective barrier method, or be non-heterosexually active, practice sexual abstinence or have a vasectomized partner) from screening throughout the duration of study treatment and for 24 weeks after the last dose of RIBA. Female subjects who utilize hormonal contraceptive as one of their birth control methods must have used the same method for at least three months prior to study dosing. Female subjects who are postmenopausal for less than two years are required to have FSH > 40 mIU/mL. If the FSH is ≤ 40 mIU/mL, the subject must agree to use highly effective method of birth control (as described above) to participate in the study. Male subjects who are sexually active must be willing to use effective barrier contraception (e.g., condom with spermicide) during heterosexual intercourse from screening through completion of the study and continue for 24 weeks after the last dose of RIBA Exclusion Criteria: Pregnant or breast feeding women or women who may wish to become pregnant during the course of the study Males who have partners planning to become pregnant Males and females of reproductive potential who are unwilling to use two forms of effective birth control through Study Week 72. One method should include a condom with spermicide for males Infection with non-genotype 1 HCV Poorly controlled diabetes mellitus (hemoglobin A1c > 7) unless treatment intervention has been reviewed with the Medical Monitor and improved glucose control is anticipated History of sarcoidosis History of hemoglobinopathy (e.g., thalassemia) History of known retinal disease History of invasive malignancy diagnosed or treated within 5 years (recent localized treatment of squamous or non-invasive basal cell skin cancers is permitted; cervical carcinoma in situ is allowed if appropriately treated prior to screen) Evidence of hepatocellular carcinoma Chronic liver disease of a non-HCV etiology Untreated or significant psychiatric illnesses including severe depression, schizophrenia, psychosis, or a history of a suicide attempt Co-infection with HIV, HBV, or multiple HCV genotypes Chronic use of systemic immunosuppressive agents Presence of autoimmune disorders. Subjects with treated hypothyroidism with normal TSH may be enrolled. Severe chronic obstructive pulmonary disease History of clinically significant cardiac disease, including a family history of Long QT Syndrome, and/or evidence of the following ECG abnormalities at screening: QTcF (QT corrected using Fridericia's formula) of > 450 msec; complete or incomplete left or right bundle branch block; intraventricular conduction delay with QRS duration of > 120 msec; bradycardia (< 45 beats per minute); pathologic Q-waves (Q wave of > 40 msec or depth of > 0.4 to 0.5 V); arrhythmia (an isolated premature ventricular contraction on screening/Day 1 is not exclusionary) ; ventricular pre excitation; second or third degree heart block Positive urine screen for amphetamines or cocaine Known, current heroin, morphine, or methadone use Ongoing alcohol abuse in the judgment of the investigator (in no case intake of more than 28 units of alcohol per week [1 unit = ½ pint of beer, 1 glass of wine, 1 shot of spirits]) Receiving a known potent CYP 3A4 inhibitor within 2 weeks of study drug dosing or are expected to receive such therapy during the course of study drug dosing Known hypersensitivity to the study drugs, their metabolites or formulation excipients In the judgment of the Investigator, should not participate in the study due to potential clinical or compliance issues
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven Knox
Organizational Affiliation
Gilead Sciences
Official's Role
Study Chair
Facility Information:
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
City
Newport Beach
State/Province
California
ZIP/Postal Code
92663
Country
United States
City
San Clemente
State/Province
California
ZIP/Postal Code
92673
Country
United States
City
San Diego
State/Province
California
ZIP/Postal Code
92115
Country
United States
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80110
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
City
North Miami Beach
State/Province
Florida
ZIP/Postal Code
33162
Country
United States
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34243
Country
United States
City
Tampa
State/Province
Florida
ZIP/Postal Code
33613
Country
United States
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
City
Decatur
State/Province
Georgia
ZIP/Postal Code
30033
Country
United States
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
City
Bowling Green
State/Province
Kentucky
ZIP/Postal Code
42101
Country
United States
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70809
Country
United States
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21229
Country
United States
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63104
Country
United States
City
Cedar Knolls
State/Province
New Jersey
ZIP/Postal Code
07927
Country
United States
City
Johnson City
State/Province
New York
ZIP/Postal Code
13790
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10029-6574
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
City
Plainview
State/Province
New York
ZIP/Postal Code
11803
Country
United States
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28801
Country
United States
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
City
High Point
State/Province
North Carolina
ZIP/Postal Code
27262
Country
United States
City
Cincinatti
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
City
Tulsa
State/Province
Oklahoma
ZIP/Postal Code
74104
Country
United States
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138
Country
United States
City
Dallas
State/Province
Texas
ZIP/Postal Code
75208
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77090
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
City
Annandale
State/Province
Virginia
ZIP/Postal Code
22003-6800
Country
United States
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22031
Country
United States
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23502-3927
Country
United States
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
City
Bruxelles
ZIP/Postal Code
B-1070
Country
Belgium
City
Bruxelles
ZIP/Postal Code
B-1200
Country
Belgium
City
Ghent
ZIP/Postal Code
B-9000
Country
Belgium
City
Leuven
Country
Belgium
City
Liege
Country
Belgium
City
Berlin
ZIP/Postal Code
10969
Country
Germany
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
City
Hamburg
ZIP/Postal Code
20099
Country
Germany
City
Hannover
ZIP/Postal Code
30625
Country
Germany
City
Koln
ZIP/Postal Code
50921
Country
Germany
City
Munchen
ZIP/Postal Code
80336
Country
Germany
City
Dublin
ZIP/Postal Code
8
Country
Ireland
City
Dublin
ZIP/Postal Code
9
Country
Ireland
City
Dublin
Country
Ireland
City
Bialystok
ZIP/Postal Code
15-540
Country
Poland
City
Bydgoszcz
ZIP/Postal Code
85-030
Country
Poland
City
Chorzow
Country
Poland
City
Czeladz
ZIP/Postal Code
41-250
Country
Poland
City
Krakow
ZIP/Postal Code
31-501
Country
Poland
City
Warszawa
ZIP/Postal Code
01-201
Country
Poland
City
Santurce
ZIP/Postal Code
00909
Country
Puerto Rico
City
Birmingham
ZIP/Postal Code
B15 2TH
Country
United Kingdom
City
London
ZIP/Postal Code
E1 1BB
Country
United Kingdom
City
London
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Safety, Tolerability, and Antiviral Activity of 24 or 48 Weeks of GS-9190 in Combination With Peginterferon Alfa 2a and Ribavirin for the Treatment of Genotype-1 Chronic HCV Infection

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